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Why EMS Recruitment and Retention Remain Ongoing Problems

By Allison G. S. Knox
Edge Contributor

For years, the emergency medical services (EMS) industry has been plagued by a shortfall of EMS providers. This shortage of EMS providers is very serious because it affects patient care – particularly in emergency situations.

Imagine, for example, that there is someone who desperately needs prehospital medical care but cannot be assisted by an ambulance crew because of the shortage. As a result, people who are in need of emergency care will not receive the prehospital care that saves their lives. 

EMS policy scholars have written about recruitment and retention, citing problems with patient care and that many rural EMS agencies simply cannot staff their ambulances due to recruitment and retention problems. But why is it so difficult for the EMS industry to recruit quality individuals right now?

Poor Salaries and Their Role in EMS Recruitment and Retention

Some EMS policy scholars argue that for many EMS practitioners, the problems with recruitment and retention stems from their pay. The average emergency medical technician (EMT) salary nationwide is $17 per hour, a salary that is far too low. Other EMTs and paramedics do not even get paid for their efforts; they volunteer. 

The salary debate has been a point of contention in the EMS industry for decades. Until more communities take steps to improve the wages of their EMS providers, the salary will remain a reason why it is difficult to effectively recruit and retain new EMS personnel.

How EMS Workplace Culture Affects Recruitment and Retention

Workplace culture is often tied to high employee turnover and is also connected to poor management styles. To understand the reasons why EMS agencies are having such a difficult time, it may be worthwhile to examine whether there are cultural issues affecting recruitment and retention within their own departments.

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For instance, is there micromanagement, proper communication, accountability or a lack of trust? Clearly, more research is needed within EMS agencies to see if their internal culture has staffing problems.

We need to quickly find solutions to the EMS recruitment and retention dilemma. Otherwise, patient care will be negatively impacted, and more lives will be lost without emergency care.

Allison G.S. Knox

Allison G. S. Knox teaches in the fire science and emergency management departments at the University. Focusing on emergency management and emergency medical services policy, she often writes and advocates about these issues. Allison works as an Intermittent Emergency Management Specialist in the Administration for Strategic Preparedness and Response. She also serves as the At-Large Director of the National Association of Emergency Medical Technicians, Chancellor of the Southeast Region on the Board of Trustees with Pi Gamma Mu International Honor Society in Social Sciences, chair of Pi Gamma Mu’s Leadership Development Program and Assistant Editor for the International Journal of Paramedicine. Prior to teaching, Allison worked for a member of Congress in Washington, D.C. and in a Level One trauma center emergency department. She is an emergency medical technician and holds five master’s degrees.

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